PICO stands for Population, Intervention, Comparison, and Outcomes. The study
focuses on adults with heart failure. The study compares the incidence of heart failure
between Hispanic and non-Hispanic populations. The interventions are nurse-led since the
patients are recovering from serious conditions and discharge from the emergency
department relies on task performance. The study relies on the increased nurse confidence in
the performance of tasks as well as reducing the rate of readmission in emergency care and
thus lowering the cost of services. The outcome is the reduced risk for readmission and the
stabilization of heart failure patients during the discharge process. Therefore, confidence is a
crucial element in patients with heart failure since it determines the experiences in the
delivery of care.
1. Statement of importance with 2 facts such as costs, mortality, safety include statistics
An overview of the affected population indicates that the incidence of heart failure is
high in Hispanic populations. The socio-economic status, racial and ethnic disparities affect
the effective delivery of healthcare and patient outcomes. Statistics indicate that 5.7 million
people suffered from heart failure in 2012 and the number rose to 6.5 million in 2014
(Sepulveda-Pacsi, 2019). The increase in heart failure readmission is attributed to the lack of
patient education and the failure to adhere to medication schedules. These deficiencies in
patients cause an increased risk of heart exacerbation and thus increasing the cost of
Paragraph 2 C. Summary paragraph for the nursing quantitative research article
EMERGENCY NURSES AND CHF PATIENT PROCESS DISCHARGE 3
Registered Nurses are crucial in the delivery of healthcare for heart failure patients.
Also, the RNs are part of multidisciplinary teams and they play different roles in patient care
such as diagnostic tests and identification of symptoms for heart failure patients. Also, they
are pivotal in monitoring patient needs, observing culturally-tailored needs for the patients.
To properly attend to emergencies for heart failure patients, RNs should demonstrate high
levels of confidence in discharging patients. The study focuses on descriptive and cross-
sectional methods to understand the RNs ability to perceive the patient’s needs in the
emergency discharge. This process involves a review of instructions and other health
concerns before discharge. Based on the study, a total of 60 RN nurses in the ED participated
in the interviews (Sepulveda-Pacsi, 2019). The results are focused on confidence levels and
experience. The nurses’ experience with electronic medical records was essential in the
discharge process. A brief discussion of the results reveals a consistency in confidence levels
and the development of criteria in the discharge process leads to stabilized patients and
D. Paragraph 3: Reliability paragraph
Reliability focuses on the stability and consistency of results in measuring different
study phenomena. Reliable results rely on constant conditions to bring an objective result.
Measuring instruments should be consistent to bring about high confidence levels on the
results. The study focuses on reliable data collection methods such as self-report
questionnaires; the use of questionnaires brings about consistency in the results. Reliance on
consistency is evident in the sample choice. The application of inclusion criteria in the choice
of RNs is illustrated by the use of full-time, part-time, travelers RNs, and the per diem
nursing professionals (Taherdoost, 2016). The use of the self-confidence scale improves the
reliability of data in the study. The self-confidence is used in the development of
EMERGENCY NURSES AND CHF PATIENT PROCESS DISCHARGE 4
E. Paragraph 4: Validity paragraph
Validity focuses on the collected data and how well the methods explain the topic of
investigation. According to Taherdoost, (2016), “measure what is intended to be measured”
the use of face, content, and criterion validity is significant in this study. The face validity
measures the data collection methods and linguistic and analytical techniques. The content
validity focuses on measurement items such as data collection and measurement techniques.
The criterion validity analyzes the extent to which different measures relate. For example, the
effective use of exploratory studies in the study ensures its validity. Questionnaires are valid
data collection methods since the guide the respondent to present objective information. Also,
the method is valid since it produces accurate and consistent responses from the respondents.
Therefore, validity and reliability are crucial in data collection, measurement, and analysis
since they determine the applicability of the results.
F. Paragraph 5: Strengths or Weakness
The study strength is evident in its ability to directly connect nursing practice and confidence
to patient experiences in the emergency department. The data collection and measurement
techniques are specific; this means that they use a specified point (emergency department and
discharge) to gauge patient experiences and nursing abilities. A weakness in the study is the
use of self-confidence which is a hard concept to generalize in a study (Sepulveda-Pacsi,
2019). Besides, the sample size is small and it limits the generalizability of the results.
G. Paragraph 6: Clinical Practice and guideline summary
Heart failure is a serious conduction that affects a certain percentage of adults and the
clinical guidelines from multiple organizations recommend the need to optimize patient care.
Also, the provision of systematic procedures and reviews during discharge is crucial to
reduce the causes of readmission. Due to the nature of the heart conditions, the analysis of
beneficial care options for the patients and thus the need for consistency and confidence by
EMERGENCY NURSES AND CHF PATIENT PROCESS DISCHARGE 5
the nurses (Iyngkaran et al., 2018). For example, the New York Heart Association focuses on
reducing mortality and other issues affecting heart failure patients. According to Sepulveda-
Pacsi, (2019), the nurses at the emergency discharge play a significant role in reducing
readmission and hospital visits. Despite the complexities involved with patients with heart
failure, effective nursing practices plays an important role in improving patient experiences
and reducing the rate of readmission.
H. Paragraph 7: Resource Summary
Based on the analysis from Sepulveda-Pacsi, (2019), emergency nurses are key to
patient care and the discharge of stabilized patients. There is a need for confidence in the
delivery of services. The focus on the Hispanic population with heart failure is crucial to the
study since it identifies the health disparities that exist in society. The element of confidence
is part and parcel of nursing since the nurse should review and address the patient's needs and
concerns confidently. Besides, confidence helps in the discharge process since the nurse has
to coordinate with the relevant health personnel in the treatment and post-care phase. The
source explores nursing as multidisciplinary and the different professionals focus on patient
care. The treatment and discharge process should focus on evidence-based approaches to
promote patient care. The Incorporation of a multidisciplinary team in the treatment and
discharge process enhances confidence as well as effective healthcare experiences.
According to Iyngkaran et al., (2018), there are different forms of heart conditions,
and the understanding the comorbidity of each condition guides in clinical practice. The
identification of different gaps in patient traits leads to reduced readmissions and the effective
delivery of care. Sepulveda-Pacsi, (2019), provides a study on the nursing confidence on the
discharge process and its effects on nurses. The source is crucial in the identification of the
disparities that exist between Hispanic and Non-Hispanic patients. The last source outlines
EMERGENCY NURSES AND CHF PATIENT PROCESS DISCHARGE 6
how a researcher can attain valid and reliable results through effective data collection and
, P., Liew, D., Neil, C., Driscoll, A., Marwick, T. H., & Hare, D. L. (2018). Moving from
heart failure guidelines to clinical practice: Gaps contributing to readmissions in
patients with multiple comorbidities and older age. Clinical Medicine Insights:
Cardiology, 12, 117954681880935. https://doi.org/10.1177/1179546818809358
Sepulveda-Pacsi, A. L. (2019). Emergency nurses’ perceived confidence in participating in
the discharge process of congestive heart failure patients from the emergency
department: A quantitative study. Hispanic Health Care International, 17(1), 30-35.
Taherdoost, H. (2016). Validity and reliability of the research instrument; How to test the
validation of a questionnaire/Survey in research. SSRN Electronic Journal.